Jacqueline Stark, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

3393 Issued in CA

Practice address

3350 W Ball Rd
Anesthesia Department
Anaheim, CA 92804-3710

Phone

(714) 827-6700

NPI assigned

Jul 7, 2005

Last updated

Jul 15, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Allied Anesthesia Medical Group IncGroup PAC ID 6103728407, 185 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Allied Anesthesia Medical Group Inc

  • Anesthesiology Physician
  • Orange, CA
  • NPI 1346267267
  Medicare reassignment Care Compare group NPD
• Norya Inc

  • Certified Registered Nurse Anesthetist
  • Mission Viejo, CA
  • NPI 1023583184

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD Authorized official
• County of Los Angeles

  dba County of Los Angeles Harbor UCLA Medical Center

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1851363188
  Medicare reassignment NPD
• Horieh Anesthesia Services

  • Certified Registered Nurse Anesthetist
  • Irvine, CA
  • NPI 1346953007

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Lgibson Anesthesia Inc

  • Certified Registered Nurse Anesthetist
  • Rancho Cucamonga, CA
  • NPI 1417473323

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Metro Nursing Anesthesia Services Inc.

  • Certified Registered Nurse Anesthetist
  • Bellflower, CA
  • NPI 1093970436

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Universal Pain Management Medical Corporation

  • Specialist
  • Palmdale, CA
  • NPI 1427046655
  Medicare reassignment NPD
• Blue Wave Anesthesia Group, Inc.

  • Anesthesiology Physician
  • Anaheim, CA
  • NPI 1033440987
  NPD
• County of Los Angeles

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1295407401
  NPD
• Universal Pain Management Medical Corp

  • Pain Medicine (Anesthesiology) Physician
  • Valencia, CA
  • NPI 1942502687
  NPD
• Metro Nursing Anesthesia Services Inc

  • Certified Registered Nurse Anesthetist
  • Los Angeles, CA
  • NPI 1578915005

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Anesthesia Associates of Savannah ,PA

  • Anesthesiology Physician
  • Savannah, GA
  • NPI 1487663688
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279152000000",
    "number": "1396742284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N TUSTIN AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053807",
            "telephone_number": "714-347-1010",
            "fax_number": "714-647-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 W BALL RD",
            "address_2": "ANESTHESIA DEPARTMENT",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043710",
            "telephone_number": "714-827-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "JACQUELINE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-07",
        "last_updated": "2010-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "3393",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MD",
            "license": "R148323",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000831101",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Massi Stahr, SLPA
• Standard Care Hospice, Inc. (Saint Francis Hospice and Palliative)
• Standard Care Medical Associates Inc
• Rachel Janell Stanford-Maffey, LMFT
• Meredith L Stanton, LMFT
• Starlight Startbright Inc
• State College Dental Group
• State College Physical Therapy
• State College Physical Therapy Inc (Anaheim Hills Physical Therapy & Rehabilitation)
• Richard Anthony Stea, MD

• Certified Registered Nurse Anesthetist in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Certified Registered Nurse Anesthetist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.